This is the best and easiest way to figure out the skincare products and regimen for you to look and feel your best! By answering the short list of questions below, I can customize some simple recommendations based on any concerns you might be having. I am so excited to get you started!
Name (First and Last)
Select the option that best describes your skin type:
Normal (no or few blemishes, balanced, etc.)
Oily (dull or shiny complexion, blackheads and breakouts more common, large pores common)
Dry (dull or rough complexion, irritation common, flaky)
Combination (areas of both dry and oily skin, usually along the forehead nose and chin)
Sensitive (does not tolerate many products well, redness, irritation, itchy, burning common)
Acne prone skin
Do you have any of the following concerns (check as many as apply to you)?
Acne scars from historic acne
General overproduction of oil
Skin spots or discoloration
Eczema or dermatitis
A known reaction to skincare products
Redness or uneven skin tones
If you have had a reaction to skincare products in the past, please tell me more about which product(s) you reacted to and what type of symptoms you experienced.
What does your current skincare routine consist of? Please include the following information: Product and brand name, time of day used (i.e. morning or night), list products in order of application.
Do you have a budget in mind? If so, what range would you like to stay in to get started? Keep in mind I will provide you with 3 different options that will allow you to pick and choose products to stay within budget.
Less than $50
$200 or more
I’m open, depending on what is needed
Are you interested in hearing about our cosmetic line and receiving recommendations on products?
No, not at this time.
If interested in cosmetics, please tell me a little bit about which products you currently use and would be interested in replacing with safer options.
Please list any other concerns or question you might have here. I am happy to support you any way that I can!
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service